There are surgical apparatus (e.g., powered surgical apparatus) that are configured so as to enhance shaving, cutting and/or removal of tissue, bone and/or other bodily material. Such surgical apparatus can include a shaving or cutting instrument, such as a rotating blade or a rotating burr for example. The rotating cutting implement also is connected to a hand piece which is held by an operator of the apparatus, such as a surgeon, for example. The surgeon, by holding the hand piece in their hand, can manipulate the rotating cutting implement to grind, shave or cut desired tissue, bone and/or other bodily material.
However, tissue abrading burrs used in connection with conventional surgical procedures can cause heating of the tissue being reduced or abraded. Such heating becomes an issue or concern when the heating begins to modify the tissue being reduced through the temperature rise attributable to the rotating burr or cutting element rather than through the intended mechanical abrasion. Such heating also can cause heating of the surrounding tissue thereby also leading to collateral tissue being damaged. For example, devices embodying such rotating burrs in connection with ear, nose and throat (ENT) surgical procedures can lead to collateral tissue damage as well as accidental tissue damage during extraction.
One conventional technique used to limit the effects of heating while using a rotating surgical cutting instrument (e.g., when grinding, reducing or modifying tissue, bone or teeth in a human body) involves irrigation of the surgical site with a fluid or liquid such as water or saline solution. In this technique, the fluid (e.g., water or saline) solution is actively dispersed (e.g., pumped, sprayed) at the surgical site and suction is concurrently applied to remove the fluid as well as any debris (e.g., tissue, bone, etc.) that is contained in the fluid. In this way, the fluid being dispersed can absorb the heat energy and the thus heated fluid is removed by suction.
In further embodiments, the surgical instrument can be configured so it disperses or suctions the fluid and/or a separate device(s) can be provided to disperse and suction the fluid. Such techniques, however, may not be suitable for all surgical procedures or introduce added complexities because the introduction of a fluid at a given site in a sufficient quantity to control temperature rise may not be optimal.
Referring now to U.S. Pat. No. 6,733,501 there is found an electrosurgical device having electrodes to cauterize, cut and/or coagulate tissues. In such a device, RF energy or the like is applied to the tissues using one or more electrodes to achieve the desired surgical effect. However, such cutting or cauterizing of the tissue also can cause less than optimal initial conditions for the procedure. The described electrosurgical device is configured with a heat pipe that conducts heat from the electrode where substantially all of the heat conducted from the electrode through the heat pipe is dissipated along the length of the heat pipe.
Such a heat pipe includes an internal cavity which is sealed at both ends. The cavity is partially evacuated and contains a heat transfer fluid such as water. The outer shell can be made of a conductive metallic material such as copper. The shell can be covered over most of its length by an electrically insulating cover or sheath. The exposed distal end of the heat pipe is coated with a conductive non-toxic material such as gold or nickel, for example, which forms an outer surface.
Referring now to U.S. Pat. No. 6,736,837 there is found a method for inducing hypothermia for treating neurological disorders, more particularly the invention relates generally to methods of treating cancer and other diseases by modulating body temperature. In this regard, body temperature may be directly modulated by a heat-exchange catheter positioned within a blood vessel of a patient. Such methods generally relate to methods of treating cancer by inducing hypothermia. In this technique, heat is directed to the hypothalamus, while optionally maintaining cancerous tissue at or near to normal body temperature, and optionally applying another cancer treatment. This other cancer treatment may be radiation therapy, chemotherapy, a combination of radiation and chemotherapy, or some other cancer treatment. The invention relates generally to methods of treating diseases including cancer, viral infections, and other diseases, comprising inducing hyperthermia by cooling the hypothalamus, and optionally applying another treatment, for example radiation, chemotherapy, antiviral therapy, or a combination of therapies.
Another such apparatus effective to cool a nasal passage or sinus comprises an electrical cooling device attached at an end of a flexible tube, rod or catheter capable of being introduced into the nasal passage or sinus. Such an electrical cooling device may be a Peltier device or other electrical cooling element. The Peltier device may be located at the tip of the cooling device or may be located distal to the tip and heat withdrawn from the tip by the cooling device via a heat pipe. The tip of the probe may be cooled via a heat pipe that connects the tip of the probe to a cooling element such as the Peltier device. It also is noted therein that heat pipes are described, for example, in U.S. Pat. No. 5,190,539 to Fletcher et al. and U.S. Pat. No. 5,417,686 to Peterson et al.
Referring now to U.S. Pat. No. 7,998,159 there is found an irrigated cutting device for use with a powered surgical tool. Such a device includes an elongated outer tube with an outer hub attached to the proximal end for releasably securing the cutting accessory/device within the powered tool. An elongated inner member is received within the outer tube and has an inner hub adapted to be driven by the surgical tool. The dimensions of the outer tube and inner member are such as to form an annular channel there between for the passage of irrigating fluid. The inner member carries a cutting tool, such as a burr, at its distal end, the tool being accessible through an aperture in the outer tube. A bypass channel runs external to the outer tube to carry irrigating fluid to the cutting tool. An aperture through the outer tube connects the annular channel with the bypass channel.
The fluid passes through the aperture into the external bypass tube, and along the bypass tube before exiting adjacent the burr. In this way, the irrigating fluid is directed on to the burr, to provide the maximum cooling and irrigating effect. Excess fluid, as well as tissue and bone fragments cut by the burr, pass through the suction aperture into the interior of the hollow member, and travel back up the cutting blade under the action of the suction source.
Referring now to U.S. Pat. No. 8,491,585, there is found methods and systems for minimally invasive lateral decompression of one or more spinal nerves. Such a system for laterally decompressing includes an access sheath, a tool guide, and a bone removal tool. The bone removal tool is used to remove bone from the anterior surface. Optionally, after bone removal has been completed, the cutting tool may be advanced through the access sheath in order to partially cut the ligamentum flavum to further relieve compression of the spinal nerve(s). Usually, a cooling and/or flushing medium will be introduced to the rotating burr in order to remove heat and optionally permit aspiration of the removed bone material.
Referring now to U.S. Publication No. US2013/01729191 there is found a tissue removal kit or assembly that includes a cannula and a tissue removal probe axially slidable within the cannula. The tissue removal probe includes an elongated member having a distal end configured to curve when distally deployed from the cannula. The tissue removal probe further comprises a drive shaft and a rotatable tissue removal element (e.g., an abrasive burr) disposed on the drive shaft adjacent the member distal end. The curved member distal end may associate the tissue removal element, which has its own axis of rotation, with a radius of revolution about the longitudinal axis of the member. The member is laterally flexible and resilient, so that the radius of revolution can be adjusted. In this manner, the tissue removal element can remove tissue around an adjustable arc. An irrigation fluid is provided to help cool the drive shaft and/or the burr, while the burr is rotating at high speed and grinding against tissue. The media or fluid also washes away debris at the target site.
It thus would be desirable to provide a surgical instrument having a cutting or abrading cutting element such as a burr that embodies a mechanism for directly cooling the cutting element or burr to minimize temperature rise in surrounding tissue as well as methods related thereto. It would be particularly desirable to provide such a surgical instrument, surgical apparatus and method that would minimize temperature rise when using the surgical instrument in comparison to prior art devices, apparatus and methods.